Silvera Stephanie A Navarro, Miller Anthony B, Rohan Thomas E
Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Rm. 1301, New York, NY 10461, USA.
Int J Cancer. 2006 Mar 1;118(5):1321-4. doi: 10.1002/ijc.21467.
The etiology of glioma, the most commonly diagnosed malignant brain tumor among adults in the United States, is poorly understood. Given the lower incidence rate of glioma in women than in men, it has been hypothesized that reproductive and hormonal factors may be involved in the etiology of glioma. We conducted a secondary analysis of data from the National Breast Screening Study, which included 89,835 Canadian women, aged 40-59 years at recruitment between 1980 and 1985. Linkages to national cancer and mortality databases yielded data on cancer incidence and deaths from all causes, respectively, with follow-up ending between 1998 and 2000. Cox proportional hazards models were used to estimate hazard ratios and 95% confidence intervals (CI) for the association between hormonal and reproductive factors and risk of glioma. During a mean of 16.4 years of follow-up, we observed 120 incident glioma cases. Compared with women with a relatively early age at menarche (< or =12 years), women who were 13-14 years of age at menarche had a 64% increased risk of glioma (95% CI = 1.01-2.65), and women who were older than 14 years of age at menarche had a 66% increased risk of glioma (95% CI = 0.86-3.20, p(trend) = 0.06). Age at first live birth, parity, menopausal status, use of oral contraceptive and use of hormone replacement therapy were not associated with altered glioma risk in our study population. Additional prospective studies are needed to confirm our findings.
在美国成年人中最常被诊断出的恶性脑肿瘤——胶质瘤的病因，目前还知之甚少。鉴于女性胶质瘤发病率低于男性，有人推测生殖和激素因素可能与胶质瘤的病因有关。我们对国家乳腺筛查研究的数据进行了二次分析，该研究纳入了89835名加拿大女性，她们在1980年至1985年招募时年龄为40 - 59岁。与国家癌症和死亡率数据库的关联分别产生了癌症发病率和全因死亡数据，随访期在1998年至2000年结束。采用Cox比例风险模型来估计激素和生殖因素与胶质瘤风险之间关联的风险比和95%置信区间（CI）。在平均16.4年的随访期间，我们观察到120例新发胶质瘤病例。与月经初潮年龄相对较早（≤12岁）的女性相比，月经初潮年龄在13 - 14岁的女性患胶质瘤的风险增加了64%（95% CI = 1.01 - 2.65），月经初潮年龄大于14岁的女性患胶质瘤的风险增加了66%（95% CI = 0.86 - 3.20，p趋势 = 0.06）。首次生育年龄、产次、绝经状态、口服避孕药的使用和激素替代疗法在我们的研究人群中与胶质瘤风险改变无关。需要更多的前瞻性研究来证实我们 findings。 （注：这里“findings”直接保留英文，可能是原文笔误，推测应为“findings”的复数形式“findings”，表示“研究结果”，翻译时应根据语境灵活处理，这里直接翻译为“研究结果”更合适，但按照要求保留英文。）
